/pdf/pathology-and-genetics-of-tumours-of-the-digestive-system-3xy9cwrc3c.pdf

Pathology and genetics of tumours of the digestive system

Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines.

Ers/ests clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy) . a. brunelli, a. charloux, c.t. bolliger, g. rocco, j-p. sculier, g. varela

Pathology and genetics: Tumours of the digestive system

Identifying genetic alterations that prime a cancer cell to respond to a particular therapeutic agent can facilitate the development of precision cancer medicines. Cancer cell-line (CCL) profiling of small-molecule sensitivity has emerged as an unbiased method to assess the relationships between genetic or cellular features of CCLs and small-molecule response. Here, we developed annotated cluster multidimensional enrichment analysis to explore the associations between groups of small molecules and groups of CCLs in a new, quantitative sensitivity dataset. This analysis reveals insights into small-molecule mechanisms of action, and genomic features that associate with CCL response to small-molecule treatment. We are able to recapitulate known relationships between FDA-approved therapies and cancer dependencies and to uncover new relationships, including for KRAS -mutant cancers and neuroblastoma. To enable the cancer community to explore these data, and to generate novel hypotheses, we created an updated version of the Cancer Therapeutic Response Portal (CTRP v2).

Significance: We present the largest CCL sensitivity dataset yet available, and an analysis method integrating information from multiple CCLs and multiple small molecules to identify CCL response predictors robustly. We updated the CTRP to enable the cancer research community to leverage these data and analyses. Cancer Discov; 5(11); 1210–23. ©2015 AACR .

See related commentary by Gray and Mills, [p. 1130][1] .

This article is highlighted in the In This Issue feature, [p. 1111][2]

 [1]: /lookup/volpage/5/1130?iss=11
 [2]: /lookup/volpage/5/1111?iss=11

https://cancerdiscovery.aacrjournals.org/content/candisc/early/2015/10/14/2159-8290.CD-15-0235.full.pdf

Harnessing Connectivity in a Large-Scale Small-Molecule Sensitivity Dataset.

Purpose: To analyze the significance of the number of metastatic lymph nodes on survival with and without the addition of prophylactic postoperative radiotherapy (RT) after radical resection of thoracic esophageal carcinoma. Methods and Materials: A total of 549 thoracic esophageal squamous cell cancer patients who had undergone radical resection were randomized by the envelope method into a surgery-alone group (S, n = 275) and a surgery plus RT group (S+R, n = 274). We performed a retrospective review of all patients according to the extent of metastasis. The patients were classified into three groups: Group 1, 269 patients (49.0%) without lymph node involvement; Group 2, 159 patients (29.0%) with one to two positive nodes; and Group 3, 121 patients (22.0%) with three or more positive lymph nodes. Results: For the same T stage (T3), the 5-year survival rate for Groups 1, 2, and 3 was 50.6%, 29.3%, and 11.7%, respectively ( p = 0.0000). For patients with Stage III, the 5-year survival rate for Groups 1 (T4N0M0), 2 (T3-T4N1M0), and 3 (T3-T4N2M0) was 58.1%, 30.6%, and 14.4%, respectively ( p = 0.0092). The 5-year survival rate of the S and S+R groups with positive lymph nodes (Groups 2 and 3) was 17.6% and 34.1% ( p = 0.0378). In the positive lymph node groups, the incidence of failure by intrathoracic lymph node metastasis and supraclavicular lymph node metastasis in the S+R group (21.5% and 4.6%, respectively) was lower than in the S group (35.9% and 19.7%, respectively; p p = 0.006). Hematogenous metastasis was the greatest (27.5%) in Group 3 (three or more positive lymph nodes). Conclusion: The number of metastatic lymph nodes is one of the important factors affecting the survival of patients with thoracic esophageal carcinoma. In our study, postoperative RT improved the survival of patients with positive lymph nodes. Additionally, postoperative RT reduced the incidence of intrathoracic recurrence and supraclavicular lymph node metastasis for all patients.

Influence of number of metastatic lymph nodes on survival of curative resected thoracic esophageal cancer patients and value of radiotherapy: Report of 549 cases

http://lib.ajaums.ac.ir/booklist/1-s2.0-S0003497514005931-main.pdf

Epidermal growth factor receptor is a prognosis predictor in patients with esophageal squamous cell carcinoma.

The overall survival of patients with esophageal squamous cell carcinoma (ESCC) remains poor. Prognostic predictions in ESCC are usually based on histological assessment of tumor invasion and lymph node metastasis, but a biomarker with better predictive accuracy could be more useful. Because overexpression of epidermal growth factor receptor (EGFR) has been associated with poor prognosis, this study investigated whether EGFR is an independent prognostic factor for overall survival and disease-free survival of ESCC patients. ESCC tissue specimens from 243 patients obtained during surgical resection between 1980 and 1997 were retrieved for immunohistochemical analysis of EGFR expression. The data showed that EGFR protein was overexpressed in 187 of 243 (77%) ESCC tissues. Elevated expression was associated with higher pathologic tumor stages (P = 0.001), lymph node metastasis (P = 0.002), and higher Union for International Cancer Control (UICC) stage (P <0.0001), as well as poorer disease-free survival and overall survival of ESCC patients (P <0.0001). A multivariate analysis showed that overexpression of EGFR protein was an independent factor for disease-free survival (P = 0.003) and overall survival (P = 0.001) of these patients. Subgroup analysis of patients with stage IIA (UICC 2002) showed that EGFR overexpression was associated with poorer disease-free survival (P = 0.007) and overall survival (P = 0.010) of the patients in univariate analyses. The current study demonstrated that EGFR overexpression was an independent prognostic factor for overall survival and disease-free survival of ESCC patients. However, targeting of EGFR activity using gefitinib or erlotinib could be useful for clinical treatment of ESCC patients.

/pdf/expression-of-epidermal-growth-factor-receptor-is-an-ycualcd4fs.pdf

Expression of epidermal growth factor receptor is an independent prognostic factor for esophageal squamous cell carcinoma

Background Primary small cell carcinoma of the esophagus is rareAlthough surgery is successful in eradicating local tumor,the five-year survival rate of patients with primary small cell carcinoma of the esophagus after resection is lower than that of patients with primary squamous cell carcinoma of the esophagusThe purpose of this study was to analyze the clinical manifestations,pathological features and treatment of primary small cell carcinoma of the esophagus Methods A total of 73 patients with primary small cell carcinoma of the esophagus who had been treated by surgery from 1984 to 2003 were analyzed retrospectively Results In this series,the overall resection rate was 945% (69/73),the radical resection rate 890% (65/73) and the operative mortality 14% (1/73)The 1-,3-and 5-year survival rates of patients were 507%,137% and 82%, respectively Conclusions Primary small cell carcinoma of the esophagus is rare with a poor prognosisSurgical resection is the leading method for patients with stage Ⅰ or Ⅱ primary small cell carcinoma of the esophagusPostoperative chemotherapy is beneficial to these patientsThe patients of stage Ⅲ or Ⅳ should be given chemotherapy and radiation therapy Chin Med J 2007;120(5):355-358

Management of primary small cell carcinoma of the esophagus.

Background: Due to the popularity of video-assisted thoracic surgery (VATS) techniques in clinical, thymoma patients via VATS thymectomy are increasing rapidly. However, compared with open thymectomy, the potential superiorities and defects of VATS thymectomy remain controversial.
 Methods: A number of 129 patients who underwent thymectomy of early stage thymoma (Masaoka stage I and stage II) in one single center from January 2007 to September 2013 were selected in this retrospective study. Of those patients, 38 thymoma patients underwent VATS thymectomy (VATS group) and 91 underwent open thymectomy (open group) via either transsternal [44] or transthoracic approach [47] in the same period. The postoperative variables, which included postoperative hospital length of stay (LOS), the intensive care unit (ICU) LOS, the entire resection ratio, the number of thoracic drainage tubes, the quantity of output and duration of drainage, were analyzed. Meanwhile, the operation time and blood loss were considered as intraoperative variables.
 Results: All thymoma patients in the analysis included 19 thymoma patients with myasthenia gravis, among which five patients via VATS thymectomy and 14 patients via open thymectomy respectively. There was no death or morbidity due to the surgical procedures perioperatively. The ICU LOS, operation time, entire resection ratio, and the number of chest tubes were not significantly different in two groups. The postoperative hospital LOS of VATS thymectomy was shorter than that of open thymectomy (5.26 versus 8.32 days, P<0.001). The blood loss of VATS thymectomy was less than open thymectomy (114.74 versus 194.51 mL, P=0.002). Postoperatively, the quantity of chest tubes output in VATS group was less than that in open thymectomy group (617.86 versus 850.08 mL, P=0.007) and duration of drainage in VATS group was shorter than that in open thymectomy group (3.87 versus 5.22 days, P<0.001).
 Conclusions: VATS thymectomy is a safe and practicable treatment for early-stage thymoma patients. Thymoma according with Masaoka staging I-II without evident invading seems to be performed through VATS approach appropriately, which has shorter postoperative hospital LOS, less blood loss and less restrictions to activities, hence patients will recover sooner.

Kelin Sun

Papers

Influence of number of metastatic lymph nodes on survival of curative resected thoracic esophageal cancer patients and value of radiotherapy: Report of 549 cases

Epidermal growth factor receptor is a prognosis predictor in patients with esophageal squamous cell carcinoma.

Expression of epidermal growth factor receptor is an independent prognostic factor for esophageal squamous cell carcinoma

Management of primary small cell carcinoma of the esophagus.

Comparative study of video-assisted thoracic surgery versus open thymectomy for thymoma in one single center.